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Reference values for Doppler indexes of left ventricular diastolic filling in the elderly
A Sagie1, E J Benjamin, M Galderisi
1Framingham Heart Study, MA 01701.
Insights
Reference values for Doppler indexes of left ventricular (LV) diastolic filling were established in healthy elderly individuals. Findings indicate a slight age-related decline in LV inflow, with most subjects showing a ratio less than 1.0.
Area of Science:
- Cardiology
- Gerontology
- Medical Imaging
Background:
- Congestive heart failure prevalence rises with age, often linked to diastolic dysfunction in the elderly.
- Left ventricular (LV) diastolic dysfunction is a key factor in heart failure symptoms among older adults with preserved systolic function.
- Establishing reference values for LV diastolic filling in the very elderly is crucial for accurate diagnosis.
Purpose of the Study:
- To generate reference values for Doppler indexes of LV diastolic filling in a healthy elderly population.
- To assess the relationship between age, sex, and Doppler-derived LV diastolic function parameters.
- To provide normative data for diagnosing diastolic dysfunction in older individuals.
Main Methods:
- Doppler echocardiography was used to evaluate 114 healthy subjects (aged 70-87) from the Framingham Heart Study.
- Seven common Doppler indexes of LV diastolic filling were measured.
- Statistical analyses, including stepwise regression, identified factors influencing LV diastolic filling.
Main Results:
- Reference values for Doppler diastolic indexes were generated for the healthy elderly cohort.
- A slight, progressive decline in LV inflow indexes was observed with increasing age.
- In 87% of participants, the ratio of peak early to late LV diastolic inflow velocities was below 1.0.
Conclusions:
- Normative Doppler echocardiographic values for LV diastolic filling in healthy elderly individuals were established.
- Age is a significant factor influencing LV diastolic filling parameters in this population.
- The findings highlight the prevalence of altered diastolic filling patterns in healthy aging.
Abstract:
Congestive heart failure increases in prevalence with age. A large number of elderly subjects with heart failure have either normal or slightly reduced left ventricular (LV) systolic function; their symptoms are due to diastolic LV dysfunction. Reference values for Doppler indexes of LV diastolic filling in a large sample of the very elderly (> 70) have not been reported previously. The objective of this study was to generate reference values for Doppler indexes of LV filling in a population of apparently healthy elderly men and women. A total of 1201 surviving original subjects of the Framingham Heart Study were evaluated by Doppler echocardiography. A subset of 114 rigorously selected healthy subjects (26 men and 88 women) aged 70 to 87 years (mean 76) constituted the study group. Measurements of seven commonly used Doppler indexes were obtained. Mean and 2.5, 5, 10, 25, 50, 75, 90, 95, and 97.5 percentile values for Doppler diastolic indexes were generated. Stepwise regression analyses were performed to determine the relation of diastolic LV filling to age group (70 to 74 years, 75 to 79 years, and 80 years and over), sex, and other clinical variables. Reference values for the various Doppler parameters were generated on the basis of this healthy elderly cohort. There was evidence for a slight progressive decline in indexes of LV inflow with age. In 87% of this elderly population the ratio of peak early to late velocities of LV diastolic inflow was less than 1.0.(ABSTRACT TRUNCATED AT 250 WORDS)